Provider Demographics
NPI:1518123686
Name:GOEKE, JUDITH K (LPC)
Entity Type:Individual
Prefix:PROF
First Name:JUDITH
Middle Name:K
Last Name:GOEKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1746
Mailing Address - Country:US
Mailing Address - Phone:970-493-2530
Mailing Address - Fax:
Practice Address - Street 1:315 W OAK ST
Practice Address - Street 2:5 TH FLOOR
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2722
Practice Address - Country:US
Practice Address - Phone:970-493-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health